Researchers say the tool could bring sharper diagnosis without adding to the workload of already stretched GPs.
A self-administered digital cognitive test developed at Lund University in Sweden may help general practitioners decide which patients with memory concerns should be tested for Alzheimer’s disease.
The tool, calledBioCog, is designed for use in primary care and offers a faster, more precise alternative to traditional pen-and-paper screening methods.
“This digital test, which patients perform on their own with minimal involvement from healthcare personnel, improves the primary care physician’s ability to determine who should be further examined by blood tests for Alzheimer’s pathology early in the investigation phase,” said study co-lead Professor Oskar Hansson.
BioCog has been evaluated in real-world primary care populations, involving two cohorts of 223 and 403 patients who sought help at their health centres with concerns about memory or other cognitive problems.
Findings have been published in Nature Medicine this week.
Patients complete the test independently on a tablet, carrying out a series of tasks designed to assess memory, attention, processing speed, orientation, delayed recall and recognition.
The digital format makes it possible to capture details that paper-based tests cannot, such as response times and search patterns, providing a more objective and nuanced profile of cognitive function.
The test measures:
- memory (memorising 10 words);
- cognitive processing speed and attention;
- orientation (what year, day etc.);
- delayed recall (recalling previously memorised information); and
- recognition (among 30 words, recognise the 10 words previously memorised);
Patients whose results indicate cognitive impairment can then be referred for blood biomarker testing, such as phosphorylated tau, which reliably indicates Alzheimer’s pathology.
At present, these tests are available only in specialist memory clinics, but they are expected to move into primary care in the future.
Professor Hansson noted that primary care often lacked the time, resources and expertise to investigate possible Alzheimer’s disease in the same way as specialist clinics, and that this was where a digital cognitive test could make the greatest difference.
“Primary care does not have the resources, time or specialist knowledge to investigate possible Alzheimer’s disease in the same way as specialised memory clinics. And this is where a digital cognitive test can make the biggest difference,” said Professor Hansson.
Alzheimer’s disease is the most common cause of dementia, and with new disease-modifying treatments becoming available, early and accurate diagnosis is increasingly important.
Identifying patients who may benefit from treatment, while avoiding unnecessary investigations in those whose symptoms stem from other causes such as depression, fatigue or other dementias, is critical.
The researchers believe that their digital tool could be of great benefit, as it was currently very challenging to diagnose Alzheimer’s disease during a 15 to 20-minute patient encounter.
They said that digital tools, which measure cognitive skills in an objective way, could make a big difference.
“The unique aspect of our BioCog test is that unlike other digital tests, it has been evaluated in a primary care population, i.e. patients seeking treatment at a health centre because they are experiencing cognitive problems, such as memory problems.” said Linda Karlsson, a member of the Clinical Memory Research group at Lund University.
“Combining the results of the digital test and the blood test increases the accuracy of diagnosing Alzheimer’s disease. The purpose of the test is to make things easier for primary care doctors.”
Dementia has surpassed heart disease and cancer to become the leading cause of death for Australians.
The Australian Institute of Health and Welfare’s (AIHW) Dementia in Australia report found that there were 17,400 deaths because of dementia in 2023, with more women than men dying due to the condition.
For women, it’s the leading cause of death, whereas coronary heart disease still claims more men.
